Decellularization of a Fasciocutaneous Flap for Use as a Perfusable Scaffold

Qu, Jin; Hogezand, Rose M. van; Zhao, Chunfeng; Kuo, Benjamin Jyhhan; Carlsen, Brian T.

doi:10.1097/sap.0000000000000157

Cited by 27 publications

(30 citation statements)

References 24 publications

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“…Thus, skin/adipose tissue flap engineering has tremendous impact in the field of reconstructive surgery. Studies have shown that a completely decellularized skin flap matrix retains its vascular structure intact [13, 14]. However, details about the characterization of the acellular skin flap matrix are lacking, and the interaction between the cells and scaffold matrix during the remodeling process has not yet been investigated in vitro or in vivo .…”

Section: Introductionmentioning

confidence: 99%

Decellularized skin/adipose tissue flap matrix for engineering vascularized composite soft tissue flaps

et al. 2016

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Using a perfusion decellularization protocol, we developed a decellularized skin/adipose tissue flap (DSAF) comprising extracellular matrix (ECM) and intact vasculature. Our DSAF had a dominant vascular pedicle, microcirculatory vascularity, and a sensory nerve network and retained three-dimensional (3D) nanofibrous structures well. DSAF, which was composed of collagen and laminin with well-preserved growth factors (e.g., vascular endothelial growth factor, basic fibroblast growth factor), was successfully repopulated with human adipose-derived stem cells (hASCs) and human umbilical vein endothelial cells (HUVECs), which integrated with DSAF and formed 3D aggregates and vessel-like structures in vitro. We used microsurgery techniques to re-anastomose the recellularized DSAF into nude rats. In vivo, the engineered flap construct underwent neovascularization and constructive remodeling, which was characterized by the predominant infiltration of M2 macrophages and significant adipose tissue formation at 3 months postoperatively. Our results indicate that DSAF co-cultured with hASCs and HUVECs is a promising platform for vascularized soft tissue flap engineering. This platform is not limited by the flap size, as the entire construct can be immediately perfused by the recellularized vascular network following simple re-integration into the host using conventional microsurgical techniques.

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Section: Introductionmentioning

confidence: 99%

Decellularized skin/adipose tissue flap matrix for engineering vascularized composite soft tissue flaps

et al. 2016

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“…Perfusion decellularization and recellularization has shown promising preclinical results for transplantation of organs (e.g., heart, lung, kidney, and liver) and complex tissues (e.g., limbs, face, ears, fascio‐cutaneous flaps) in small and large animal models . Henderson et al and Qu et al have described effective decellularization of a small fascio‐cutaneous flap based on SIE vessels in rats . Duisit et al decellularized hemi‐facial grafts in rats and decellularized/recellularized both human facial grafts and porcine ears .…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18][19][20][21][22] Henderson et al and Qu et al have described effective decellularization of a small fascio-cutaneous flap based on SIE vessels in rats. 28,29 Duisit et al decellularized hemi-facial grafts in rats and decellularized/recellularized both human facial grafts and porcine ears. 20,21,30 Recently, Jank et al successfully decellularized/recellularized entire limbs in rats and primates and a complex fascio-cutaneous flap in swine.…”

Section: Discussionmentioning

confidence: 99%

Development of a large‐volume human‐derived adipose acellular allogenic flap by perfusion decellularization

Giatsidis

Guyette

Ott

et al. 2018

Wound Repair Regeneration

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In reconstructive surgery, transfer of patients' tissue (autologous flaps) is routinely used to repair large soft tissue defects caused by surgery, trauma, chronic diseases, or malformations; unfortunately, this strategy is not always possible and often creates a secondary defect in the donor site of the tissue. Tissue-engineered synthetic flaps are currently unable to repair clinically-relevant, large-volume defects; allogenic flaps from cadaveric donors could provide a ready-to-use biological alternative if treated with methods to avoid the immune-rejection of the donor's cells. Here, we describe the successful decellularization of a large (> 800 cc) human-derived adipose flap through a perfusion apparatus; we demonstrate the complete removal of the immunogenic cellular components of the flap with the retention of its structural components and vascular network. Our aim is to obtain a universally compatible, off-the-shelf acellular allogenic flap that could be recellularized with cells from recipient patients to provide a tissue-engineered allogenic/autologous alternative for reconstruction of large-volume soft-tissue defects.

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“…A skin flap consists of healthy skin and fat or skin, fat, and muscle. 46 This optimized protocol has been successfully reported in miniature swine model. Hence, the decellularization of skin flaps is essential.…”

Section: Decellularized Skin Flapsmentioning

confidence: 91%

“…Dvir and coworkers began decellularization procedures with freeze/thaw cycles, demonstrating that freezing was necessary to completely remove nuclei and DNA 31,32 ; however, freeze/thaw cycles would disrupt the microstructure of ECM. 46 Despite remarkable differences in decellularization techniques, all protocols have shown complete removal of nuclei and reduction in DNA content as well as preservation of ECM microstructure together with the major components of the ECM such as collagen, elastin, laminin, and glycosaminoglycans. 33,34,36 During skin flaps decellularization, agitation and perfusion decellularization are demonstrated to be effective, while perfusion treatment could retain the vascular structure well, compare to agitation.…”

Section: Protocols For Decellularizationmentioning

confidence: 99%

Progress in developing decellularized bioscaffolds for enhancing skin construction

Cui

Chai

2019

J Biomedical Materials Res

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The skin is the largest organ in the human body, and skin defects are very common. Skin flap transplantation is the best treatment for serious wound defects, and donor site tissues are always sacrificed during this process. Decellularized biomaterials, derived mainly from various nonautologous organs and tissues, have promising applications in tissue engineering and repair of wound defects. To date, decellularized mesothelium, intestine, amniotic membrane, dermis, and skin flaps have been developed and applied for skin coverage in animal models and clinical practice. In this review, we discuss recent advances in decellularized biomaterials for skin substitutes and future perspectives. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1849–1859, 2019.

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Decellularization of a Fasciocutaneous Flap for Use as a Perfusable Scaffold

Cited by 27 publications

References 24 publications

Decellularized skin/adipose tissue flap matrix for engineering vascularized composite soft tissue flaps

Decellularized skin/adipose tissue flap matrix for engineering vascularized composite soft tissue flaps

Development of a large‐volume human‐derived adipose acellular allogenic flap by perfusion decellularization

Progress in developing decellularized bioscaffolds for enhancing skin construction

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